Denis MacShane: May I welcome, as I am sure the Foreign Secretary does, the arrest of Ratko Mladic and his dispatch to The Hague? Eight thousand Europeans were taken out and shot one by one in the biggest single mass murder since Katyn. It was not, if I may say so, Britain’s finest hour in foreign policy.
	As we move forward in the Balkans, will the Foreign Secretary join me in urging President Tadic and responsible Serb politicians to recognise Kosovo, and to stop the blocks to Kosovo trading in the region and those that stop it joining international institutions? The reason that Kosovo has the economic problems to which the hon. Member for West Worcestershire (Harriett Baldwin) referred, is that Serbia will not allow it—

Michael Dugher: According to answers to written ministerial questions in January, only 1% of European Union aid to the Palestinians goes to civil society projects. What are the Government doing to ensure that a greater proportion of EU aid is spent on developing the co-existence projects that are so vital to the peace process?

William Hague: Our military role is defined by United Nations Security Council resolution 1973, and it is our implementation of that resolution that has saved thousands of lives. I know that the hon. Gentleman is an opponent of the resolution, but if we had not had it, far, far more people would have died than have done so thus far in the situation in Libya. It is, additionally, true that we believe Colonel Gaddafi should go, but that is the belief of the vast majority of nations in the world—even many around Africa now, and even Russia at the G8 summit—and, judging from what I saw in Benghazi, it is the belief of a vast number of Libyans as well.

Jo Swinson: Europe stands united in condemnation of the atrocities perpetrated by the Syrian regime, but progress in getting the Security Council similarly to declare condemnation of these abuses is frustratingly slow. The support of countries such as Brazil, South Africa and India could reduce the likelihood of a Russian or Chinese veto, which highlights the importance of these emerging powers. What steps are the Government are taking to strengthen further the ties between Britain and the emerging powers, in terms not just of trade but of shared interests, such as human rights?

Caroline Spelman: First, I wish to make it clear that the written ministerial statement was available to Members before I spoke to the Chartered Institution of Wastes Management. Of course the Government will work with all parties to increase recycling rates, but the recycling target is a European one of reducing waste by 50% by 2020. I am confident that we are on target. This is a devolved matter for the other nations.
	It is a bit rich, coming from the Opposition, who had 13 years to get to grips with landfill. They could, if they had so wanted, got on and banned wood, materials, textiles and metals. I fear that the Opposition are still in denial about the dreadful economic legacy that they left to the Government.
	Finally, the hon. Gentleman asks about green growth. I have just spoken to the Chartered Institution of Wastes Management and shared with them the fact that we estimate that there will be a growth of 3% or 4% per annum in green jobs through the waste industry because of the positive framework that we are setting out to help people do what they want to do—the right thing—waste less and recycle more.

Anne McIntosh: I welcome the statement that the Secretary of State laid before the House today. May I share with her the fact that the district council serving my part of north Yorkshire will be well on its way to meeting the target that she has set. There will obviously be some perverse implications from abolishing LATS because rural communities have done very well out of that.
	I welcome the fact that anaerobic digestion is to be increased. It deals primarily with waste food. What are the implications for other energy from waste facilities in the next few years?

Caroline Spelman: I thank my hon. Friend for a question that obviously shows that he has read the review. He will know that it contains the startling fact that we waste £12 billion worth of food a year, something that we can ill afford to do. We need to work with all involved in food production and packaging to try to minimise the amount of food waste.

Caroline Spelman: I agree with my hon. Friend that waste services are a matter for local authorities and that they should develop fit for purpose local solutions. However, the Government believe that better procurement and joint working can improve the efficiency of collections while improving the front-line service for the public in an affordable and practical manner.

Caroline Spelman: There were perverse incentives in the regime in place under the previous Government. As it have mentioned, LATS actually deterred the collection and recycling of business waste, so their abolition, which was a coalition agreement commitment, will
	re-incentivise councils to collect and recycle more business waste. We want to help to make it easier for small and medium-sized enterprises, in particular, to benefit.

Anne Main: I welcome the fact that small businesses can now have their waste collected count towards recycling targets. Will my right hon. Friend therefore lobby her friends in DECC in the hope of introducing a renewables obligation certificate for recycled cooking oil that could be used as a biofuel?

Andrew Lansley: Thank you very much, Mr Speaker.
	We will further clarify the duties on the NHS commissioning board and clinical commissioning groups to involve patients, carers and the public. Commissioning groups will have to consult the public on their annual commissioning plans and involve them in any changes that would affect patient services.
	One of the main ways in which patients will influence the NHS is through the exercise of informed choice. We will amend the Bill to strengthen and emphasise the commissioners’ duty to promote patient choice. The choice of any qualified provider will be limited to areas where there is a national or local tariff, ensuring that competition is based solely on quality. The tariff development, alongside a best-value approach to tendered services, will safeguard against cherry-picking.
	Monitor’s core duty will be to protect and promote the interests of patients. We will remove its duty to promote competition as though that were an end in itself. Instead, it will be under a duty to support services integrated around the needs of patients and the continuous improvement of quality.
	It will have a power to tackle specific abuses and restrictions of competition that act against patients’ interests. Competition will be a means by which NHS commissioners are able to improve the quality of services for patients.
	We will keep the existing competition rules introduced by the last Government—the so-styled “Principles and rules for cooperation and competition”—and give them a firmer statutory underpinning. The co-operation and competition panel, which oversees the rules, will transfer to Monitor and retain its distinct identity. We will also amend the Bill to make it illegal for the Secretary of State or the regulator to encourage the growth of one type of provider over another. There must be a level playing field.
	We will strengthen the role of health and wellbeing boards in local councils, ensuring that they are involved throughout the commissioning process and that local health service plans are aligned with local health and wellbeing strategies.
	In a number of areas, we will make the timetable for change more flexible to ensure that no one is forced to take on new responsibilities before they are ready, while enabling those who are ready to make faster progress. If any of the remaining NHS trusts cannot meet foundation trust criteria by 2014, we will support them to achieve that subsequently. However, all NHS trusts will be required to become foundation trusts as soon as clinically feasible, with an agreed deadline for each trust.
	We will ensure a safe and robust transition for the education and training system. It is vital that change is introduced carefully and without creating instability, and we will take the time to get it right, as the Future Forum has recommended. During the transition, we will retain postgraduate deaneries and give them a clear home within the NHS family.
	The extension of “any qualified provider” will be phased carefully to reflect and support the availability of choice for patients. Strategic health authorities and primary care trusts will cease to exist in April 2013. By that date, all GP practices will be members of either a fully or partly authorised clinical commissioning group, or one in shadow form. There will be no two-tier NHS.
	However, individual clinical commissioning groups will not be authorised to take over any part of the commissioning budget until they are ready to do so. Individual GPs need not take managerial responsibility in a commissioning group if they do not want to, and April 2013 will not be a “drop dead” date for the new commissioners. Where a clinical commissioning group is not able to take on some or all aspects of commissioning, the local arms of the NHS commissioning board will commission on its behalf. Those groups that are keen to press on will not in any way be prevented from becoming fully authorised as soon as they are ready.
	I told the House on 4 April that we would secure proper scrutiny for any changes that we made to the Bill. In order to do that without trespassing on the House’s time to review the Bill as a whole on Report, we will ask the House to recommit the relevant parts of the Bill to a Public Bill Committee shortly.
	Through the recommendations of the NHS Future Forum and our response, we have demonstrated our willingness to listen and to improve our plans; to make big changes, and not to abandon the principles of reform, which the forum itself said were supported
	across the service. However, we are clear that the NHS is too important, and modernisation too vital, for us not to be sure of getting the legislation right. The service can adapt and improve as we modernise and change, but the legislation cannot be continuously changed. On the contrary, it must be an enduring structure and statement, so it must reflect our commitment to the NHS constitution and values and incorporate the safeguards and accountabilities that we require. It must protect and enhance patients’ rights and services, and it must be crystal clear about the duties and priorities that we will expect of all NHS bodies and local government in the future.
	Professor Field’s report says that it is time for the pause to end. Strengthened by the forum’s report and recommendations, we will now ask the House to re-engage with delivering the changes and modernisation that the NHS needs. I commend this statement to the House.

Andrew Lansley: Well, I was hoping that, having got past the abuse, the right hon. Gentleman would tell us whether he agreed with the NHS Future Forum, but he did not even mention it. He welcomed the listening and engagement exercise that we announced—he said it was the right thing and that it would be good government to do it—but then when an independent group of experts reports and makes recommendations, he ignores it and says he will oppose the Bill regardless. He did not listen to what people in the NHS were saying. I think it was shameful how he dismissed everything that has happened over the past year as though it did not matter at all—a year in which the coalition Government said we would increase resources to the NHS. We have done that and are committing to investing an extra £11.5 billion in the NHS over the next four years. That is money that, as we will continue to remind the British public, the Labour party told us we should not give to the NHS.
	In the past year, the coalition Government and the NHS across the country have implemented a cancer drugs fund from which 2,500 more patients have benefited, and in the past four months, we have cut the number of breaches of the single-sex rule by three quarters, and the number of hospital infections by 22% and C. difficile infections by 15%. Some 750,000 more people are accessing dentistry, and waiting times for people going into hospital are down compared to March 2010. We said that we would reduce management costs, and we will do so, and we have taken 3,800 managers out of the NHS since the election, while the number of doctors has gone up. Six months ago, the right hon. Gentleman said that he supported the reform principles in the Bill. All he said today was sheer opportunism, but it will come back to haunt him, because the NHS will benefit from the
	changes we are proposing today. It will take greater ownership of its own service; patients will be empowered; and clinicians across the service will be empowered and will deliver better outcomes for patients, and when that happens, we will be able to say, “The Labour party would have denied the NHS the resources and the freedom and responsibility to deliver those better outcomes.”

Mr Speaker: Order. The Opposition Front-Bench team should not be yelling at the Secretary of State when he is answering. [Interruption.] Order. On both sides of the House, right hon. and hon. Members, whatever the passions they feel, need to simmer down just a little. And a fine example of that calm and stoicism can now be provided by the right hon. Member for Holborn and St Pancras (Frank Dobson).

Frank Dobson: Does the Secretary of State not recognise that pretending to produce a collaborative silk purse out of a competitive pig’s ear will not work?

Andrew Lansley: It is slightly confusing, because the right hon. Gentleman’s right hon. Friend on the Opposition Front Bench, the Member for Wentworth and Dearne (John Healey), was just telling us—erroneously—that we could have done this without legislation anyway, but now the right hon. Gentleman is accusing us of proceeding without legislation. It is not true: we are doing things in the NHS by way of changes that are absolutely essential in any case. I have to tell him and the House that sustaining the structure that we inherited from the Labour party, with all the strategic health authorities and all the primary care trusts—this vast bureaucracy—is something that could never have happened. We had to take out administration costs in the service, and empower clinicians and patients, and we are doing it now regardless of whether the legislation has made progress or not.

Andrew Lansley: I am grateful to my hon. Friend. I have to tell him that there are many things that are beyond many of us to understand. One of them is the Labour party and the way it approaches policy. As he and the House will know, the fact is that the Labour party has no policy; it simply had opposition for opposition’s sake.

Dennis Skinner: Does not the Secretary of State understand that when the Labour Government were in power, they increased spending
	from £33 billion to £111 billion in one decade, and that we are now witnessing, at a cost of £2 billion, a new Frankenstein monster all to pacify these tin-pot Liberals? Judas only got 30 pieces of silver?

Andrew Lansley: I do not think that the hon. Gentleman listened to or heard the Prime Minister when he made absolutely clear our commitment to keeping waiting times low. Not only did the Prime Minister make that commitment, but it is also in the constitution. In practice, the opportunity for patients increasingly to see the performance of the hospitals to which they can choose to go will help to drive increases in performance. As I told the House in response to an earlier question, waiting times are now lower for in-patients and out-patients than at the time of the last election. I am also old enough to remember that in June 1944, Winston Churchill, as the leader of a coalition Government, went to the Royal College of Physicians and set out an ambition for a national health service that would give everybody in the country access to the highest quality health care, free for all, regardless of means.

Andrew Lansley: I repeat: from the public’s point of view, we know that what they wanted was genuine accountability, in the sense that the doctors, nurses and other health professionals who care for them should be able directly to design and influence the shape of services locally to meet their needs, but they also want there to be a patient voice and a public voice. That has not existed in the past; we will enable it to happen. They will come together at the health and wellbeing board, where they will establish a strategy for their area.

Kevin Brennan: Some say that the reason the Secretary of State went too far, too fast and has now come up with a fix that is too little, too late is that he has a bit of a tendency to be pig-headed and cloth-eared when people disagree with him. I do not agree with those who say that, but could he now find the humility and courage at least to say sorry for the mess he has made.

Andrew Lansley: The Future Forum is perfectly clear that there is a benefit associated with integrating health and social care if clinical commissioning groups do not
	normally cross local authority boundaries. But it is clear, and we are clear, that they should be able to make a case to do so if they think it appropriate to do so. We have the benefit of being able to look at the pathfinder consortia, of which there are 220 and I think that 16 cross local authority boundaries, so it is already the exception rather than the rule.

Andrew Lansley: The hon. Lady will have a further opportunity to discuss that with my right hon. Friend shortly. She will know that the NHS trust in Trafford is examining whether it might merge with one of two possible foundation trusts and whether it might change its corporate configuration, as it were, but entirely within the NHS.

Andrew Percy: Last Friday, I met two members of the local Labour party in my constituency who presented me with an apparently independent petition on the NHS reforms. At that meeting, they told me that it was a fact that our reforms would lead to the removal of a comprehensive health services; we now know that that is a load of old nonsense. They also told me that it was a fact that these changes would open up the NHS to European Union competition law in a way that it is not at the moment. Is that a fact, or is it just shameless scaremongering?

Phil Wilson: I beg to move,
	That leave be given to bring in a Bill to make provision for a register of private landlords; to require private landlords to take certain actions in the event of anti-social behaviour by their tenants; to give additional powers to private landlords and local authorities in cases of anti-social behaviour by tenants; to establish a community fund to which private landlords must contribute; and for connected purposes.
	In every community, the number of private landlords and the size of the private sector are increasing. It has been estimated that, by 2020, 20% of the UK’s housing stock will be private lets. At the beginning of the 21st century, about 10 years ago, 3% to 4% of the housing stock in Sedgefield was private lets. Today the figure is about 11% or 12%. In inner-city areas of London such as Camden and Newham, it is as high as 30%. Shelter estimates that the proportion of households in private lets stands at 15%—an increase of 40% over five years. Such households with children have grown at an even faster rate, increasing by 16% in just 12 months.
	With proposed changes to homelessness legislation, cuts to housing and high house prices and deposits, private renting will be under increasing pressure, especially at the lower end of the market among the most vulnerable groups. The private rented sector is rife with problems. Some 36% of Shelter advice queries come from private renters, more than double the proportion in the population at large. Satisfaction is lower, and accommodation is more likely to be of a poor standard. According to Julie Rugg’s investigation of the private rented sector in 2008, 50% of privately rented properties failed to meet the decent homes standards.
	The expansion of buy-to-let lending over the past decade saw a much wider range of individuals become landlords, many of them with little or no experience, knowledge or understanding of their responsibilities and the complex legal framework of renting. In fact, the buy-to-let sector includes more than 650,000 homes that could have been in the owner-occupier market, and the fact that they are not has helped to force up house prices.
	Where there are high concentrations of private lets, some have caused a blight on the local community, especially in low-demand areas. In Sedgefield, where there are several ex-colliery villages with rows of terraced housing, private landlords have moved in. In some streets up to 40% or 50% of the properties are private lets. In others half the landlords are absentees, with some even living abroad. Over the past four years I have had numerous cases of private landlords who have neglected their properties and tenants. Antisocial behaviour has become a major problem in the affected areas, and some of the residents who have lived in the streets in question for years now do not feel part of the local community that they have known for a long time.
	Two areas of Sedgefield—Dean Bank in Ferryhill and an area of Chilton—have been designated selective licensing areas, in which private landlords have to sign up to special conditions and protocols. They have been successful, but more needs to be done.
	The basic problem is not private landlords. Some are a problem and some are very good landlords, but the vast majority are amateurs without the skills and wherewithal to deal with being a private landlord. The buy-to-let market has led to a huge increase in such landlords. The market has grown because of people saw it as an opportunity to make capital gain, for example, from increased profits from the value of properties.
	To help the huge number of private landlords, it is in their interest for a national register to be set up. With satisfaction lower in the sector than in others, and problems with private renting leading so many people to seek advice, it is clear that private renting is not securing the needs of households and communities. The universal cover of a national register will be a significant help to local authorities in identifying and targeting rogue landlords, and in enabling better joint working between local authorities to tackle such landlords across multiple areas. Serial offenders could be struck off the list.
	In the immediate future, however the private rented sector is under increasing pressure and there is a need to strengthen local authorities’ response to tackle rouge landlords and the many amateur landlords who need help as much as anything else. The purpose of the register would be distinct from licensing. It would be mandatory and its purpose would be to enable local authorities to get a handle on the local private sector so that they can work with landlords. The register could be run by local authorities or housing associations, or it could be outsourced to a third party. A fee could be charged for administrative costs. Sanctions for failing to register could be preventing landlords from serving section 21 notices, rent payment orders or fines.
	The register could help local authorities to determine how many private landlords there are in a given area. If the number reaches a certain level, I believe that landlords should pay a community levy, especially in those areas where they dominate the housing stock. If people take out of the community, they should put back into it. If, for example, 25% of homes in a given area are private lets, or if one landlord owns several properties in an area, a community levy should be payable into a fund to put towards the upkeep of the area. Local people, in the spirit of localism, could decide how the fund is spent, whether to help with policing, environmental issues or whatever. Social landlords already do that, so why not private landlords? Again, the levy could be administered by a local authority, housing association or another arm’s length organisation. The more efficiently the community levy fund is administered, the more money will be available for investing in community programmes.
	If in nine years’ time—by 2020—one in five of our homes is a private let, the whole sector will need to be professionalised. The private rented sector is the only sector that is currently expanding. The sector is necessary, but it needs to live up to its responsibilities. I have seen that for myself in my communities.
	The sector needs regulation. Even the Rugg report says that market forces alone do not adequately police management quality in the sector. Therefore, intervention is required, not only for our communities, but for tenants and private sector landlords themselves. The Bill goes some way towards redressing the balance. In any event, I hope it raises what is a growing concern to many in the House, but more importantly, a growing concern to the people and communities whom we represent.
	Question put and agreed to.
	Ordered,
	That Phil Wilson, Tom Blenkinsop, Mrs Jenny Chapman, Nic Dakin, Lilian Greenwood, Graham Jones, Ian Mearns, Owen Smith, David Wright, Stella Creasy and Lyn Brown present the Bill.
	Phil Wilson accordingly presented the Bill.
	Bill read the First time; to be read a Second time on Friday 18 November, and to be printed (Bill 201) .

Gemma Doyle: Let me begin by paying tribute to the men and women who serve our country as reservists. They show immense dedication to serving our country. As the Minister said, we only have to look at the vital role played by reservists in Iraq and Afghanistan to understand the importance of reserve forces.
	The Government are undertaking a review into the future of reserve forces. If we are to believe what we read in the newspapers, reservists are likely to be given greater responsibility in the coming years. Indeed, the logical conclusion to draw from the strategic defence and security review is that we must seek to make the most of the assets that we have, and that includes the reserve forces. In bringing forward these amendments, the Government are perhaps pre-empting the conclusion of that review. The amendments give the Secretary of State greater powers to call in reservists. That is something that, in principle, we are more than happy to support; indeed, the Minister gave some good examples of the circumstances in which such powers would be useful. However, the Government need to be honest with the men and women of the reserve forces. If they are to ask them to do more, they also need to provide the necessary protection and support in the workplace. We are talking about people who join up to serve their country, and we have a duty to protect their jobs when they are mobilised. It is in this area that there are some questions for the Government to answer.
	We know that the Secretary of State is not necessarily on the best of terms with the Prime Minister and his other Cabinet colleagues. I wonder whether there is much joined-up thinking taking place in Government about the role of reservists and the duty of care that we owe them. The Cabinet Office has a Red Tape Challenge website, which consults the public on legislation that could or should be scrapped. When launching the site, the Prime Minister wrote to all Ministers to say:
	“We know we have inherited far too much costly, pointless, and illiberal government red tape.”
	In the employment law section of the website, item No. 1 in the list of legislation up for being scrapped is the Reserve Forces (Safeguard of Employment) Act 1985. The Act states that reservists have a liability to be mobilised and provides two kinds of protection. The first is protection of employment, providing protection from unfair dismissal and making it a criminal offence for an employer to terminate a reservist’s job without their consent solely or mainly because he or she has a liability to be mobilised. Secondly, there is a right to reinstatement. The Act provides a legal right to the reservist to be reinstated in their former job, subject to
	certain conditions. When pressed on this matter by my hon. Friend the Member for Barnsley Central (Dan Jarvis) at the most recent Defence questions, the Secretary of State refused to deny that those provisions were under consideration. The Government are therefore considering scrapping legislation that protects reserved forces employment on a day-to-day basis and when on a tour of duty.

Mark Lancaster: I should like to speak briefly in support of new clause 12, but I must start by declaring my interest as a member of the reserve forces.
	My understanding of the Reserve Forces Act 1996 is that it contains three separate sections under which a reservist may be mobilised: section 52, under which no one has been mobilised to date; section 54, which involves war fighting, and under which I was mobilised to Afghanistan; and section 56, to which the new clause relates directly, and under which I have previously been mobilised to Kosovo and Bosnia. I want to underline the points that the Under-Secretary of State for Defence, my right hon. Friend the Member for South Leicestershire (Mr Robathan) made in his opening remarks. It might seem odd that I am supporting a new clause that could result in my being mobilised even more often, but this amendment to the Act is long overdue.
	Speaking from my experience as an explosive ordnance disposal operator, I want to add to the examples that the Committee has already been given. During 2003-04, under Operation Telic in Iraq, we found that as the threat from improvised explosive devices continued to grow, the call on our EOD operators also increased. The Committee might be aware that, here in the UK, we continue regularly to dig up world war two munitions. That constant threat is covered by a 24-hour operation known as Operation Midway, which is based in Wimbish, in Cambridgeshire.
	The problem that we faced in 2004 was that, as the threat of IEDs grew in Iraq, our qualified bomb disposal officers were slowly being drawn out into theatre and we
	were struggling to cover the UK threat. Under section 56, members of the Territorial Army were mobilised to go and sit in Wimbish to cover the Operation Midway threat. It might surprise the Committee that most munitions are normally dug up on a Friday afternoon. They are invariably found on building sites, although probably not on a Friday afternoon. No one wants to interrupt the works, however, so the munitions magically seem to turn up on a Friday afternoon, which is an ideal time for the members of the Territorial Army who come in to play at weekends to deal with the munitions.
	The terms of section 56 are clear. Subsection (1)(a) states that a reservist may be mobilised only
	“on operations outside the United Kingdom for the protection of life or property”.
	Clearly, the UK disposal of munitions under Operation Midway does not count in that regard. Subsection (1)(b) states that a reservist may be mobilised
	“on operations anywhere in the world for the alleviation of distress or the preservation of life or property in time of disaster or apprehended disaster.”
	Now the problem was that although that might cover UK operations at the time, was it fair to say that the potential digging up of a world war two munition in London was a potential disaster? It was very much a grey area. What tended to happen was that people were mobilised under section 56; they sat in Wimbish for a number of months and then, right at the end of their mobilisation, they would be deployed out to theatre in Iraq simply so they could be “covered” under the mobilisation. That was obviously nonsense, which is why I believe it is so important for the Government to introduce the new clause so that in such specialised situations—along with examples that the Minister provided—we can allow reservists’ actions to continue.
	I would like to pick up on couple of points that the hon. Member for West Dunbartonshire (Gemma Doyle) made about protection of the reserve forces. We must be careful when we use these powers. Few people in the reserve forces are not prepared to be mobilised, but when we start mobilising people for the second, third or fourth time, reservists are forced to answer an important question: are they prepared to give up their first career for a second career? Protections are in place so reservists can go back to resume their employment, but many employers, who might be incredibly supportive of the reserve forces, sometimes feel quite strongly about who they should promote.

Elfyn Llwyd: I am pleased to be able to speak to the amendments, but also rather baffled by the fact that I was unable to raise my points earlier. Although I spoke on Second Reading and expressed a strong interest in being involved in the earlier Committee stage, I was unfortunately denied that opportunity. For the first time in the current Parliament, the number of Members dealing with a Bill in a Select Committee was reduced so that a representative of a minority party would not be present. I am sure that my disappointment is shared by my colleagues the hon. Members for South Antrim (Dr McCrea) and for Upper Bann (David Simpson). Be that as it may, however, I am very glad to have been given the opportunity to speak.
	My amendments and new clauses focus on the need to strengthen the provision of welfare for veterans of the armed forces, an issue on which 1 have been campaigning in the House and outside for a number of years. They would establish a more robust structure of support for personnel leaving the forces, and would ensure that veterans were not disadvantaged in any way when trying to gain access to public services as a result of the service that they had given. They were heavily influenced by the recommendations made by the justice unions parliamentary group on veterans in the criminal justice system, of which I am chair. They also deal with the need to enshrine the military covenant in law, a move that I am glad to hear that the Government will be making in the coming months via the Bill. I hoped to see a little more detail about the covenant in the Government amendments, given that the devil is always in the detail, but the Government have at least acknowledged the need to uphold, maintain and develop further that all-important relationship between our armed forces and the public.
	My amendments set out what we in the justice unions parliamentary group believe is a firm course of action to tackle the problems faced by vulnerable veterans, and it is my earnest hope that the Committee will give them due consideration. New clause 2 and amendment 2 seek to introduce a Minister for Former Armed Services Personnel, who would sit in the Cabinet Office and among whose responsibilities would be the laying of the armed forces report before Parliament each year. Most important, the Minister’s remit would extend across
	Departments, and he or she would therefore be ideally placed to tackle veterans’ issues, needs and priorities in an holistic way.
	The Bill provides for the armed forces report to be laid by the Secretary of State for Defence. I mean to cause no offence whatsoever to the present Secretary of State in arguing that a Minister with such a wide remit cannot possibly hope to dedicate as much attention to that document as I believe it deserves, and that the report should therefore be written by someone whose sole ministerial responsibility lies with veterans’ welfare and who will not be unduly compromised—in the strict sense—by other vested interests.
	Amendment 3 seeks to broaden the remit of the armed forces report, and is relevant to a number of new clauses to which I will return briefly later. Amendment 16, tabled by the hon. Member for West Dunbartonshire (Gemma Doyle), makes many of the same points. My recommendations were made before the earlier Committee stage, from which I was excluded, but I am glad that they can be raised in the Chamber now.
	As Members will know, the Bill specifies that an armed forces covenant report shall be laid before Parliament each year, and shall cover the effects had by membership, or former membership, of the armed forces seen in the fields of health care, education, and housing. Let me make the genuine observation that that is a welcome step, given that the regulation of the services available to veterans is a prerequisite for improvement of those services. I believe that the proposed report’s remits do not go far enough, however. My amendments demand that they inquire in greater depth into how having a military service background affects personnel in obtaining public services. The report should not simply discuss education, housing and health care; I have specified that it should also cover other subjects, including welfare benefits, employment advice, budgetary and life skills, debt management, alcohol and drug treatment and relationship skills.
	The most important amendment is that stipulating a series of issues to be covered in the armed forces report as, crucially, it demands that it covers far more areas. In the Select Committee, the hon. Member for West Dunbartonshire said that
	“Tony Stables of the Confederation of British Service and Ex Service Organisations—from the armed forces families federations and from the Forces Pension Society”—
	wanted the list of subjects covered by the report to be extended and that there was disappointment about their appearing to be limited to only three. I appreciate that the Secretary of State will have the power to increase the number of subjects if he desires, but, to put it simply, there is no point legislating for an armed forces report to be laid before Parliament if it provides only a limited vision of the problems it needs to address. The bare fact is that veterans do not often encounter these problems in isolation, as the factors that contribute to social estrangement are far more likely to be encountered as a package. Often, although not always, these problems arise contemporaneously; for example, employment advice cannot be fully given without due consideration also being given to debt management, further training, re-skilling and housing.
	When personnel leave the armed forces, they will almost certainly need to find a job, as the services tend to recruit their personnel at a young age, and they often retire from the services long before standard retirement age. Little advice or provision in respect of resettlement is given to service leavers, however, particularly if they have served for fewer than four years, although that largely depends on details such as their regiment and where they are stationed. This problem is particularly stark for early service leavers, and studies have shown that they are at far greater risk of suicide, substance misuse, debt, crime and homelessness. That is why it is so important that the covenant and its associated reports pertain to all veterans regardless of the period of time for which they have served.

Oliver Heald: Having served on Committees with the right hon. Gentleman, I know that he always makes an important contribution. On the question whether his proposal is the best way of ensuring all disadvantages are covered by the report, does he share my concern that by listing all the various areas, he may, in some sense, be prescribing them, and that it would be better instead to leave some discretion with the Secretary of State to be able to look at any disadvantage and report on that, because it is hard to predict exactly where such disadvantages may lie?

Elfyn Llwyd: Yes, as the hon. Gentleman humorously says, unlike in Parliament, but let me return to my serious point.
	It cannot be a coincidence that so many veterans leave active service displaying an over-dependence on alcohol. I hardly need say how quickly such a dependence can, if left totally untreated, feed into other habits, violent behaviour and crime. That is why I would like the report to address the point of counselling on substance misuse playing a vital part in, as it were, the decompression of personnel.
	As those who have worked with, or encountered, veterans grappling with social estrangement will testify, these problems often do not arise singly, but are part of a package of social hindrances faced by these individuals daily. It is thus only right that the report should take account of the multi-faceted nature of this rupture. Amendment 4 specifies that the report should take into account the recommendations of a panel of outside experts in the field, as well as specify a time frame in which they should be implemented. Proposed new subsection (2C) to clause 2 ensures that the Secretary of State is obliged to implement recommendations, rather than simply write things he or she has no intention of doing, by the fact that he or she must lay a further report before Parliament within 40 days of the laying of the initial report, explaining why certain recommendations have not been implemented.
	Amendment 3 also specifies that the report should outline the operation of the former armed services personnel rights charter, the former armed services personnel support officers, financial support for former armed services personnel welfare groups and the former armed services personnel policy forum, all of which are explained in the Bill.
	New clause 3 pertains to the former armed forces personnel rights charter, which would put in legislation an obligation on the Government to ensure that veterans undergo psychological assessment before leaving the armed forces—and possibly on entry, as has been said; that they have a resettlement assessment approximately six months before the expected date of discharge; that they have access to advice from voluntary organisations on how to combat potential problems after leaving the forces; and that they are given access to that advice in good time before they are discharged.
	At the moment, many veterans feel when that when leaving the forces people are on their own. Regardless of whether that is the case, I think we need to intensify personnel’s awareness of the support that is available to those who need it.

James Gray: I am a little uneasy about the right hon. Gentleman’s proposal about a Minister in the Cabinet Office and about the proposal made by my hon. Friend the Member for Corby (Mrs Mensch) about a Department for veterans’ affairs. It seems to me that the Secretary of State for Defence, the three services under him and under them the regiments and units to which people are attached are responsible for looking after veterans when they leave the services.
	To remove that responsibility from them and to give it to somebody else in the Cabinet Office or a separate Department would seem to me to be quite wrong.

Elfyn Llwyd: I am sure that is right—I have no argument with that—but what is to prevent signposting and sending personnel to be assessed? For example, just down the road from here is an organisation called Veterans’ Aid, which is run by Wing Commander Hugh Milroy. Under his good offices, very few ex-service people are sleeping rough in London. There was quite a number of them 10 years ago; now there are hardly any. He has done that work. There are numerous organisations doing excellent work for ex-forces personnel, but I am arguing for a more consistent approach across the piece—a more holistic approach. I could use the words “postcode lottery”: there are good services and good practice, but we need to ensure that they are accessible across the piece and across all the constituent parts of the UK, wherever veterans are, wherever they served and whichever regiment they were with.

Andrew Robathan: At the risk of incurring your wrath, Mr Gale, I am sure that the right hon. Gentleman and the House would like to join me in congratulating Wing
	Commander Milroy on his richly deserved OBE in the birthday honours only last Saturday.

Andrew Robathan: Very unlikely, if I may say so—as the hon. Lady has already suggested.
	If the hon. Lady is still in her place and there is no mention in the report of pension provision or mental health care—on which we are doing a great deal of work, as she knows; my hon. Friend the Member for South West Wiltshire (Dr Murrison) has done a lot of work for us and we are taking it forward—and she thinks that is an issue, is she telling the Committee she will not mention it?

Gemma Doyle: I give the Minister a categorical assurance that I will mention it. My concern is whether the Secretary of State will even consider those issues. As the Bill stands, he does not have to; he need only look at education, health and housing, and that is not good enough.
	I should have liked to explore further with the Minister why education, health care and housing had been chosen at the expense of the many other issues that have been of great concern over the past 12 months. However, he declined to give evidence on his Bill.
	I am also concerned that there is nothing in clause 2 that applies to Scottish or Welsh veterans. At the very least, the Bill should be amended to send a clear signal about the UK-wide responsibilities of the Secretary of State. If the family of a Scottish service person live off-base in local authority housing, their housing requirements are devolved. We have been advised that the Secretary of State will update the House even when those matters are devolved. It seems odd that such a thing could happen, because the Secretary of State is not responsible for the delivery of devolved services, nor is he or she accountable, and thus could not answer questions on the matter.

Andrew Robathan: I think the Opposition are fishing in desperation for things to get excited about, but they do not need to. I have in my hand a letter from the right hon. Alex Salmond, who describes himself as the First Minister of Scotland, for that is indeed his post. The letter is dated June, although I cannot actually read the day. It thanks the Secretary of State for Defence for his letter about the armed forces covenant and states that the Scottish Government has and will continue to provide unequivocal support for the armed forces, families and veterans. I shall not read the whole thing out, but it welcomes the new armed forces covenant as an important step forward from the 2008 service personnel Command Paper.
	There is no disagreement between us. We are in discussion with the devolved Administrations. We are interested in results, rather than the box-ticking that the hon. Lady describes.

Gemma Doyle: The letter that the right hon. Gentleman has read out does not address the point I just made. Constitutional issues are involved. I believe that it would be unconstitutional for the Secretary of State to stand at the Dispatch Box here and report on devolved matters. My understanding is that if I were to table an Adjournment debate on a devolved matter, it would not be taken on the Floor of the House. It would be ruled out of order, as indeed it should be. I am afraid that the letter to which the right hon. Gentleman refers does not address that point.
	However the process with the devolved Administrations is handled, the inclusion of pensions and benefits as a defined area in the report would ensure that the report reflected issues for service people throughout the whole United Kingdom. As the Bill stands, Scottish and Welsh veterans in particular are being ignored. Fundamentally, I want the Secretary of State to come to Parliament and report on the matters for which he or she is responsible.
	It is one thing to talk about the military covenant; the real test is how that acknowledgement is reflected in the decisions of Ministers. Their actions mean that thousands of servicemen and women will be made redundant, many more will see cuts to their allowances and all will be hit disproportionately hard compared to other workers by plans to downgrade public sector pension rises. These are just some of the many decisions taken by the Government in the past 12 months that have undermined the military covenant and given no cognisance to the unique nature of the work that our armed forces do. I am glad the Bill will recognise that through amendment 11, and I hope that Ministers will reflect that in their decision making, in which such recognition has been absent so far.

Bob Russell: This is a serious issue. To the best of my knowledge, the MOD police are an integral part of the wider military family. However, over the past 10 years the previous Government were determined, as I regret the coalition Government now appear to be, to reduce MOD police numbers to the point where I suspect at some future stage we will be told that they no longer have a purpose and can be done away with. All I can say is that where there were once 30 MOD police officers serving an exclusive Army estate in excess of 2,000 dwellings, there are now just three such officers. The expectation that Essex constabulary can suddenly conjure 27 police officers to fill that breach will not be met.
	We now have a situation in which we have Army families and civilian families and the demarcation between policing is not clear. The lifestyle of civilians is not always compatible with the military ethos of the service families. I am trying to choose my words carefully. All I am saying is that the presence of MOD police officers brought a security and comfort to military families which has been lost at the same time as the ethos of a 100% Army estate has been dramatically reduced. I put it to the Minister that the Government need to look carefully at their proposals to dramatically reduce the number of MOD police officers. It will have little effect in Colchester because 27 police officers have already been got rid of and, with only three left, we do not have much further to go.
	I welcome the armed forces covenant, previously known as the military covenant, and congratulate the Royal British Legion on all it has done. We should all be grateful to the legion. My only regret is that some people appear to be trying to turn it into a party political football.

Andrew Robathan: For those who have arrived recently, it would be discourteous of me to not respond to those who have raised points, such as the right hon. Member for Dwyfor Meirionnydd. I have yet to achieve the same length of speech as the right hon. Gentleman or the hon. Member for West Dunbartonshire. [ Interruption. ] Indeed, the night is yet young.
	The second half of amendment 3 sets out nine headings that must be covered in the annual report. I do not deny the importance of any of those topics. Some are broad and some are fairly narrow, such as “debt management” and “domestic violence”. However, it is not a comprehensive list and I am sure that other hon. Members could add many suggestions. We would rather not legislate for such a list because it may change over the next few years. The question is whether we should cram all possible issues into the legislation and turn the annual covenant report into a box-ticking exercise, or whether we want to give the Secretary of State the opportunity to identify and investigate the problems that are actually faced by service people. Amendment 3 would deny the
	Secretary of State the flexibility to deal with the effects of service that are considered to be the most important or relevant at the time of each report.
	Finally on this group of amendments I come to amendment 4, which we do not believe would add a great deal to the Bill. The Secretary of State has made it clear that he will seek views and evidence in preparing each annual covenant report. If there are issues, he will respond to them and give a time frame for implementing any recommendations. The amendment would simply get us into questions about who is and who is not an expert in this field. This country is fortunate to have an active community of well informed, constructive and articulate groups that are committed to improving the welfare of service people and want to work with the Government to achieve that. Many are brought together in the external reference group, and I can assure the right hon. Member for Dwyfor Meirionnydd that they are not slow in coming forward. We have stated that we will publish their observations alongside the annual report.
	I now turn to the official Opposition’s amendments. I know that Opposition Members who have just come in will be particularly keen to hear about them. [Interruption] Especially the hon. Member for Walthamstow (Stella Creasy).

Lyn Brown: I’m looking forward to it.

Andrew Robathan: Unfortunately, as the Members on either side of the hon. Lady—the hon. Member for North Durham (Mr Jones) and the shadow Secretary of State—will understand, I cannot speak for the Ministry of Justice. It would be beyond my remit. May I also say that she spoke for longer than I have yet achieved? Don’t worry, I’m working on it.
	New clause 13 relates to armed forces advocates. Advocates are an excellent idea, and in UK Government Departments and the devolved Administrations they face in two directions. They ensure that their own Department’s policies take account of the special needs of the armed forces community, and they communicate their Department’s perspective to my officials and external stakeholders.
	I turn briefly to new clause 14, on the ombudsmen. Ipay tribute to the parliamentary and local government ombudsmen for their work. I do not think any of us doubt the important role that they can play in helping members of the armed forces community, and they have welcomed the familiarisation events that my officials have organised. However, the new clause is unclear about what exactly the ombudsmen are intended to do, and we are not minded to accept it. The Government will continue to work with public bodies and local authorities to implement our commitments, and we will encourage them to help to remove the disadvantage faced by service people and afford them special treatment where appropriate. The ombudsmen have a vital role to play, but it is not the one described in the new clause.
	Finally—[Hon. Members: “Hooray!”] Yes, finally, I come to the Opposition’s new clause 17. Once again, the concept outlined in it is perfectly reasonable. I want, just as much as the hon. Member for West Dunbartonshire does, a world in which those who make policy take into account the needs of members of the armed forces community as a matter of routine. The best way of ensuring that we avoid problems of disadvantage is to prevent them from happening in the first place. The issue is how to achieve that. We must consider whether the right course of action is to create a legal duty to
	have regard to certain matters, or to adopt a more practical approach. In the Government’s view, placing a general duty on all public bodies and Ministers in the preparation of all policy would be unhelpful and unfocused. It would lead to more of a box-ticking culture and a cottage industry of assessments. As I have said throughout the debates on the Bill, we are interested in results and want the armed forces community to be looked after better, but that does not involve box-ticking.

Question accordingly negatived.
	Amendments made: 11, page2,line12,at end insert—
	‘(2A) In preparing an armed forces covenant report the Secretary of State must have regard in particular to—
	(a) the unique obligations of, and sacrifices made by, the armed forces;
	(b) the principle that it is desirable to remove disadvantages arising for service people from membership, or former membership, of the armed forces; and
	(c) the principle that special provision for service people may be justified by the effects on such people of membership, or former membership, of the armed forces.’.
	Amendment 12, page2,line12,at end insert—
	‘(2B) An armed forces covenant report must state whether, in the Secretary of State’s opinion, any effects covered by the report are such that service people or particular descriptions of service people are at a disadvantage as regards the field or fields in question, when compared with other persons or such descriptions of other persons as the Secretary of State considers appropriate.
	(2C) Where the Secretary of State’s opinion is that service people or particular descriptions of service people are at a disadvantage as mentioned in subsection (2B), the report must set out the Secretary of State’s response to that.’.
	Amendment 13,page2,line12,at end insert—
	‘(2D) As regards effects covered by an armed forces covenant report—
	(a) the Secretary of State must consider whether the making of special provision for service people or particular descriptions of service people would be justified; and
	(b) where the Secretary of State considers that such provision would be justified, the report must contain a reference to that fact.’.—(Mr  Robathan .)
	Clause 2, as amended, ordered to stand part of the  Bill .
	Clauses 3 to 14 agreed to.
	Schedule 1 agreed to.
	Clauses 15 to 26 agreed  to .
	Schedule 2 agreed  to .
	Clauses 27 and 28 agreed  to .
	Schedule 3 agreed  to .
	Clause 29 agreed  to .
	Schedules 4 and  5  agreed to.
	Clause 30 agreed  to .
	Clause  31, as amended, agreed  to .
	Clauses 32 and 33 agreed to.

Julian Huppert: I thank the hon. Gentleman for that point, but I think he would agree that somebody who joins on their 16th or 17th birthday currently has no right to leave, although in practice they might be allowed to, which is a slightly different issue.
	Why is this an issue for under 18s? We have a whole lot of rules for under 18s: we do not allow them to vote—although many of us think that we should because they are adult enough to do that—we do not allow them to have credit cards or to enter into other legal decisions because they are not treated as adults who are able to commit themselves for such a long time; and they cannot bind themselves to a credit agreement to pay a certain sum of money the next month, except in very exceptional circumstances. They can, however, commit themselves to an extended period in the armed forces.
	It is quite clear that in many cases they are allowed to leave, even though they do not have that right. It is hard to be sure, however, whether that covers every case of somebody under 18 who wishes to leave. We would not know if they were too scared to ask their commanding officer or if some other social pressures made it hard. We know that there are cases of bullying in the armed forces and although I am sure we all abhor the fact that that goes on, there are a number of such cases and it is hard to know what would happen then.
	The situation is unclear, so we proposed an amendment to make it absolutely clear what was and was not allowed. I am grateful to the Minister for responding to the report produced by the Select Committee on the Bill after the amendment was tabled and after a number of discussions, parliamentary questions and so on. He has made a welcome announcement, stating that
	“for those under the age of 18, the ability to be discharged will in future be a right up to the age of 18, subject to an appropriate period of consideration or cooling off.”—[Official Report, 19 May 2011; Vol. 528, c. 26WS.]
	I want to place on record my thanks to the Minister for taking that step, which is very welcome to a number of the people involved. I have a few specific questions, however, and I hope that he will be able to clarify the situation for me.
	First, what is this period of consideration or cooling off and roughly how long would it last? My amendment allowed 14 days notice; I suspect he has a different figure in mind and it would be helpful to know what it is. The second part of the JCHR’s report and of the amendment state that any person enlisting under the age of 18 should be informed of their right and I hope the Minister would agree that it would ideal for them to be told that they have it, even though he would hope that many of them would not avail themselves of it. Finally, will he update the Committee on the process as it stands? Has he given instructions that the rule should apply as of now and will people be told that there is this right? He talks about requiring secondary legislation to make such a provision, which I look forward to seeing, but when will such an instrument be laid before the House?

Andrew Robathan: I am grateful to the hon. Members for Cambridge (Dr Huppert) and for Hayes and Harlington (John McDonnell) for their compliments. I am not used to that and, as the hon. Member for Hayes and Harlington said, I do not expect it to continue. Never mind. We enjoy these things while they happen.
	I was interested in some of the comments that were made because I think the hon. Member for Cambridge is quite keen on reducing the voting age to 16, which seems not entirely at one with some of the things that were said during the debate. However, I shall not dwell on that.
	Young people who join the armed services at the ages of 16 and 17 are a valued source of manpower—it is particularly man power in the Army—but we take the duty of care seriously too. When the subject was first raised with me, I had not appreciated that there was what we might describe as a certain element of confusion over whether people could leave at the age of 18. The situation is changing, but currently if a young man—they are typically young men—approaching his 18th birthday said that he was unhappy, he would be dubbed an unhappy minor and in practice he would be allowed to go after a cooling-off period. However, the situation is slightly confused.
	People who go absent without leave do not necessarily do so because they want to leave the armed forces. The hon. Member for Hayes and Harlington might say that that is ridiculous, but sometimes people go AWOL because they have done something wrong and they do not want to face the music. There can be other reasons.
	My hon. Friend the Member for Dewsbury (Simon Reevell) has spoken to me about the situation too and, after listening to people and to the debate in the Select Committee, it seems to me that it is important to clarify the position. As the hon. Member for Cambridge said, people will have a right to leave up to the age of 18. However, I am not saying that we want them to leave, so we shall give them a cooling-off period. It is likely to be longer than two weeks. It is a genuine change and will be enacted in statute, because it is right that people
	understand that they do not have to beg to leave; they have the right to leave, but we shall make every effort to dissuade good young people from leaving if we wish to retain them.
	The hon. Gentleman asked about the time scale. People are currently informed of their rights and that will continue. The answer to his question is the old parliamentary expression, “We expect secondary legislation soon.” I hope it will be before the recess, but it may not be. I do not want to get it wrong.
	I turn to people who are less satisfied, if I can put it that way, such as the hon. Member for Hayes and Harlington. We want good young people to join the armed forces and we get a pretty high quality of recruit these days, as I think the hon. Member for North Durham (Mr Jones) would agree. Prohibiting the enlistment of people under the age of 18 would be to the detriment of the armed forces. We take real pride in the fact that the armed forces provide challenging and constructive education, training and employment opportunities for young people.
	Not all the young people who join the armed forces come from happy backgrounds. The hon. Gentleman talked about young people leaving care and joining the armed forces because they saw it as a way out of their difficult circumstances. It is important to bear that in mind.
	I shall digress if I may, although it is absolutely germane to the discussion. Probably—notwithstanding other claims—the most decorated man in the British Army at the moment has two conspicuous gallantry medals, a George medal and an MBE. He is now a lieutenant-colonel. When I met him last year, he told me that he spent the night before he joined the Army, aged 17, in a police cell in Bradford. He will not mind me saying this because he told me quite openly—[ Interruption. ] I know; being in Bradford is a bit much—[ Laughter. ] Oh God, I’ve let myself in for a few questions now. Humour never translates on to the pages of Hansard.
	That man decided that the future for him was either one that did not look very good and might involve further visits to prison and police cells, or that he would join the Army. He went and joined the Army at the age of 17 and he has not just made an outstanding career for somebody without great educational qualifications but, if I may say so, has made himself a role model for many people from disadvantaged backgrounds.

Andrew Robathan: The hon. Gentleman is right. I could not agree more. We get some very high quality people—I presented the prizes at Welbeck two weeks ago, and there is also the apprentice college, Harrogate.

Andrew Robathan: Having listened to the hon. Member for Moray (Angus Robertson), I have to say that I thought his indignation was completely synthetic. What is important is how the money is spent, not how statistics are gathered, and I will put on record what we feel.
	The Ministry of Defence has no plans to reinstate the publication of annual estimates of regional defence spending or the employment effects of that expenditure. The Department decided to stop the compilation and publication of those statistics three years ago. Although the statistics were valuable in giving national and regional employment context to defence spending, the data did not directly support MOD policy making and operations. Furthermore, the compilation of the series depended on external sources that had not been updated for some
	years. The MOD had been struggling to maintain the quality of the statistics even to a basic level. To reinstate their compilation would cost the Department about £500,000 in the next four years.
	The purpose of the defence budget is to maintain the armed forces so that they can contribute to our nation’s security—a nation that includes, I am glad to say, Scotland and Northern Ireland. Every pound that the MOD spends must contribute to the security of the United Kingdom, and it gets doled out not on a regional basis but on a defence- needs basis.

Question accordingly negatived.
	Ordered, That further consideration be now adjourned. —(Miss Chloe Smith.)  Bill to be further considered tomorrow.

Joan Walley: I am most grateful for the explanation, Madam Deputy Speaker. I was confused by the fact that this Adjournment debate started before 10 o’clock. That might explain some of my slight nervousness, as I was unsure about whether I was speaking in order with the proceedings of the House. I am grateful.
	Sustainable food procurement links to health and to hospital food, too. I want the Government to set out the role that food plays in patient pathways and the priority I believe that hospitals should give to ensuring that, where required, patients are assisted to eat the food that is served. We have heard too many shocking accounts of malnutrition and dehydration as well as the plain criticism that hospital food is bad and unappetising. We should be doing something about that.
	At the core of this debate is a central contradiction. The Government are happy to rail against regulation and boast about their bonfire of red tape, but they are equally proud—and rightly so—of their standards for the procurement of sustainable food for the Olympics and of their intentions for there to be a Government buying standard for food. They promote their localism agenda aggressively, leaving choice to those at a local level, but the net effect, I believe, is that no overall quality standard applies to the food served in hospitals. I do not see how such a postcode lottery can be justified and it I want to consider that in more detail.
	Let me turn first to malnutrition. It is not just a matter of having appetising food for patients; this can literally be a matter of life and death. In its 2009 report submitted to the Department of Health, the Nutrition Action Plan Delivery Board showed that in the region of 47,800 people had died with malnutrition while in English hospitals in 2007. Of those, 239 patients died directly because of malnutrition—that is an important distinction to make. In the report, the delivery board recommended as a key priority that the Government should clarify nutrition
	“standards and strengthen inspection and regulation”
	to address this problem. The issue is being flagged up.
	In its recent report, “Still Hungry to be Heard”, Age UK found that the number of people leaving hospital malnourished is on the increase. A recent answer to a parliamentary question from my hon. Friend the Member for Islington South and Finsbury (Emily Thornberry), placed in the Library of the House of Commons, acknowledged that from 2006-07 to 2009-10, instances of malnutrition increased in total from 2,581 to 3,773 and, as regards discharged episodes, from 2,883 to 4,412. That inevitably leads to further serious consequences, including longer stays in hospital, the need to take more medication and an increased risk of infection and even death.
	To put it in purely financial terms, the estimated cost of malnutrition to the NHS in 2006 was £7.3 billion a year. Although we do not have an accurate figure for how much it costs the NHS today, given the fact that
	malnutrition is on the increase it is likely to be higher still. I believe that the Department of Health should have up-to-date figures on the cost of malnutrition, and I urge the Minister to look into the matter and give us an indication of what the costs are.
	Dealing with malnutrition in hospitals is not simply about making food taste better. Even if we could do that, a whole range of other issues must be addressed. First, hospital staff must be aware of what food patients can and cannot eat. They need to be able to identify which patients need help with eating their meals and to be willing and able to provide that help or, if they cannot provide it, to have a robust system of volunteers to assist. Age UK has produced a seven-step guide to eradicating malnutrition in hospitals, to which I urge the Minister to give his attention. There is also an issue with dehydration and it is important to make sure that patients in hospital have proper access to water. That simply cannot be taken for granted.
	It is not only nutrition and malnutrition that need to be addressed. There must be recognition by Government of the role that healthy food plays in healthy lives. The Government estimate that 70,000 preventable deaths each year in the UK are caused by diet-related ill health. One simple thing that the Government could do to tackle that problem is to ensure that the food served to patients in hospital is nutritious. That sounds simple but the issue is how it will be done. It is also important that the Government prioritise the role of public health.
	I also want to mention the dignity and nutrition reports—[ Interruption. ] I am most grateful. Talking of dehydration, it is important that I refer to the dignity and nutrition reports recently published by the Care Quality Commission.

Joan Walley: Is not there a contradiction between having minimum standards in respect of schools and not having minimum standards that would apply in the same way to patients in hospitals?

Simon Burns: No, I do not think so, for the reasons that I have already given and because of our ethos that the modernised NHS should respond through local decision-making rather than top-down diktat from Whitehall or Westminster. However, as I have outlined, we are prepared to, and we have and we will, provide the guidance to enable local deliverers to seek advice and take decisions based on the best needs of their patients.
	We should also bear in mind that the food needs of patients are already regulated and checked by the Care Quality Commission, through the choice of suitable food, the food and nutrition to meet reasonable needs and the support to enable patients to eat and drink—a subject that I will come on to because I feel very much, as the hon. Lady did, that that is an essential part of the care of patients in a hospital setting.
	I share the hon. Lady’s concerns about poor standards of nutritional care. In too many cases, food has slipped off the menu of some NHS providers, and that is not good enough. Of course, proper nutritional care is a multidisciplinary affair. There are many links in the chain from field to fork. Food must be well sourced and properly cooked by well-trained catering staff, delivered efficiently by the porters, and properly presented on the ward. The chain is a long one, and if any single link breaks, the good work that went before it is undone. Of course, the best food is of no value if it is not eaten, and many people, particularly older patients, will need help, and they must have it. Stories of food left out of reach, or taken away before a patient has had the chance to eat it are shocking and, sadly, too common, as are stories of those unable to feed themselves left without the assistance they require.
	The latest in-patient survey found that less than two thirds—64%—of patients always got the help they needed to eat. But that sadly meant that 36% did not always get the help, which, frankly, is unacceptable. That is something that hospitals must concentrate on to ensure that we quickly and dramatically raise those figures. In a civilised society, in this day and age, that is unacceptable as part of patient care, particularly for elderly people.
	That is why we asked the CQC to inspect 100 hospitals, focusing on issues of dignity and nutrition. The CQC has begun to publish reports on individual hospitals, and we expect a final report in September. In most cases so far, the care was every bit as good as one would expect. There were many examples of high quality nursing and of people enjoying healthy, nutritious meals. Indeed, in a number of cases, the quality of food was actually complimented. But the inspections also identified a number of hospitals that were failing to provide the nutritional care their patients need. In one damning example, a doctor was forced to prescribe water on a patient's medicine chart to ensure they got enough to drink. That, again, is unacceptable, and something that one would find hard to believe if it had not shown up in the inspection. Where there are deficiencies, the CQC has demanded that improvements are made. Progress against these demands will be followed up and, like everyone in this House, I expect such follow-up to be rigorous and complete.
	The CQC's inspection programme is just one example of how we are shining a light on all aspects of the performance of NHS providers—in this case on hospital food.
	There are also the annual patient environment action team inspections, the CQC's in-patient survey and patient feedback through NHS Choices, along with any local surveys that trusts choose to undertake. This information is crucial if patients are to make informed choices about their care and if pressure is to be brought to bear upon providers to improve.
	Improving the patient experience of care is vital to drive up standards. Providers need to listen to patients’ complaints and suggestions and to change and improve in response. This will be one of the main ways in which the NHS will improve in coming years. Our information revolution will mean that patients are better placed to understand and influence the NHS, and we expect to see standards increase as performance becomes more transparent.
	When it comes to hospital food, people know what they want. They expect good-quality, wholesome meals that are attractively served, arrive on time and taste good. They want to receive the food they ordered, not what is left over. They want to be able to eat it in comfort, they want sufficient fluids to drink, and they want the help they need when they need it. That is hardly asking the earth, so we owe it to them to be clear about what they can expect in their local hospital, however good or bad it may be.
	I understand the hon. Lady’s concerns about hospitals that are built without kitchens. However, there are many ways to provide food in hospitals. Excellent meals can be delivered ready-made, either chilled or frozen, and poor-quality food is not an inevitable consequence of being made off-site. Although the quality of the food
	at the University Hospital of North Staffordshire has been rated as among the poorest 20% in the country, that is not simply because it is not made in a hospital kitchen. Other hospitals, such as Papworth hospital NHS foundation trust and Dorset county hospital NHS foundation trust, also have meals brought in and maintain in-patient survey scores that are among the highest in the country. In fact, for a small hospital, delivered meals can combine a wider choice of food and more accommodating meal times, with economies of scale and greater flexibility.
	Delivered meals can also help hospitals to meet high sustainability standards, because although on-site kitchens might at first seem more likely to be sustainable, that is not necessarily the case. Larger off-site kitchens are often more efficient because, by utilising economies of scale, they can reduce the amount of energy they use. What is important is the quality of the finished product and whether it meets the specific needs of patients, not where or by whom the food is produced or prepared. If the best solution for a particular hospital is to do that on site, that is what should happen. However, the service should be contracted out if that is in the best interests of the individual hospital and its patients. We should reject any knee-jerk reaction that says doing it in one way will automatically be a disaster, or vice versa. With food, as with all aspects of NHS care, it is the outcomes that are important to patients, not the process. We need to remember that whoever provides the food, the trust management retains the responsibility for its quality. If the provider does not meet the standards that the trust has set, it must take action.
	Of course, efficiency and value for money are also important. We have to find ways of producing excellent food at manageable cost. For some hospitals, that will certainly mean looking at delivered meals. This is sensible and prudent management, but it need not and should not mean poor quality. As long ago as 2002, the Audit Commission found no relationship between the amount of money spent on meals and their quality, and the Department of Health’s more recent internal analysis backs this up. Across the country there are trusts that provide great meals at low cost, which is precisely what all providers should aspire to. The Queen Victoria hospital NHS foundation trust is in the top 10% of NHS organisations rated by patients for having good food, but it in the lowest 5% for production costs.
	As ever, improving patient experience is central to the Government’s vision of the NHS. Good food is not only a vital element of that experience, but vital for improving clinical outcomes. However, I do not accept that the answer to these problems is to impose ever more controls that would prove expensive to administer, undermine local accountability and stifle the innovation and flexibility that hospitals need to tailor improvements to their specific local needs and constraints. Where food services are not as good as they should be, we should highlight the fact in order to improve care for patients. I do not pretend that making improvements will be easy or fast. Although there is much to do, I am confident that we now have the right approach and that the real winners in all of this will be patients.
	Question put and agreed to.
	House adjourned .